WASHINGTON — President Barack Obama Wednesday tried hard to create momentum for his ailing health care overhaul plan, offering a lengthy, methodical — and at times defensive — explanation of why Americans should embrace his changes.

Obama, whose plan has been stymied by moderate Democrats who worry about higher taxes and Republicans who paint the effort as a big government takeover of health care, told the nation in a prime time news conference that the initiative is "central" to his effort to rebuild the economy "stronger than before."

Obama's latest health care push came as his popularity has been slipping. In a July 9-13 Ipsos-McClatchy poll, 57 percent said they approved of the job Obama was doing, a 7-point drop from early June and the lowest of his presidency.

Obama was intent on explaining his push for health care, and virtually every question at the 55-minute news conference dealt with that subject.

In response to a question from McClatchy, he said that as a symbolic gesture he'd use any public option that became law.

"Not only the public option, but the insurance regulation that we want to put in place will largely match up with what members of Congress are getting through the federal employee plan," Obama said. "That's a good example of what we're trying to build for the American people."

He urged Americans to be patient, saying "We just can't afford what we're doing right now," and he appeared to be irritated by critics who say the nation can't afford the change.

"Everybody who's out there who has been ginned up about this idea that the Obama administration wants to spend and spend and spend, the fact of the matter is, is that we inherited an enormous deficit, enormous long-term debt projections," he said.

Obama opened his news conference by trying to reassure viewers "we have been able to pull our economy back from the brink."

Health care was most on his mind, however. With all the political doomsayers circling, Obama said, "Many Americans may be wondering, 'What's in this for me? How does my family stand to benefit from health insurance reform?'

"Tonight," the president said, "I want to answer those questions."

He listed a host of areas where the White House and key lawmakers have what Obama called "rough agreement."

They want to keep government out of health care decisions, "giving you the option to keep your insurance if you're happy with it," Obama said.

Any new plan "will prevent insurance companies from dropping your coverage if you get too sick," he explained. "It will give you the security of knowing that if you lose your job, move, or change your job, you will still be able to have coverage.

"It will limit the amount your insurance company can force you to pay for your medical costs out of your own pocket. And it will cover preventive care like check-ups and mammograms that save lives and money."

Small businesses and the uninsured will be able to choose coverage through "exchanges," or marketplaces that are designed to promote competition. Additionally, no company will be permitted to deny anyone coverage because of a pre-existing condition.

What's stifled progress on the legislation, though, is cost and the role of the government. Obama offered assurance to skeptics, saying he wouldn't buy any proposal that increased the federal deficit.

"It will be paid for," Obama pledged. "Already, we have estimated that two-thirds of the cost of reform can be paid for by reallocating money that is simply being wasted in federal health care programs."

Obama recalled that he wanted to limit itemized deductions for the nation's wealthiest taxpayers, a plan that went nowhere at the Capitol.

"I continue to think my idea's the best one, but I'm not foreclosing some of these other ideas," he said. One Democratic proposal would impose surcharges on the wealthiest Americans.

Obama reiterated his oft-stated pledge that the middle class wouldn't see higher taxes to pay for health care. While not endorsing a specific version of the surcharge, he said, "that meets my principle that it's not being shouldered by families who are already having a tough time."

He said that while there'd be changes in the health care delivery system, they'd be for the better.

"And the government already is making some of these decisions. More importantly, insurance companies right now are making those decisions," he said. "And part of what we want to do is to make sure that those decisions are being made by doctors and medical experts based on evidence, based on what works."

He's got a rough fight ahead in convincing Congress that he can pay for health care without hurting the middle class, however. Last week, the nonpartisan Congressional Budget Office said the current House of Representatives proposal would add $239 billion to the already-record federal deficit over the next 10 years.

Moderate-to-conservative House Democrats, or "Blue Dogs," found that figure daunting and want more spending cuts before they'll agree to anything.

House Speaker Nancy Pelosi, D-Calif., said Wednesday that she's optimistic an agreement will be reached. "Some of the issues that the Blue Dogs have put forth are issues that we are all concerned about," she said.

"We are making progress," she added, "and I have no question that we have the votes on the floor of the House to pass this legislation."

Obama had said that he wants the Senate and House to pass health care legislation before they leave for their summer recesses. The House is scheduled to leave July 31; the Senate a week later.

Even those deadlines are now in doubt, however, and Obama said Wednesday "we will do it this year."

Why the rush, he was asked. "I'm rushed because I get letters every day from families that are being clobbered by health care costs," he explained.

He'd tie himself to a specific deadline, however. "Now I do think it's important to get this right, and if, at the end of the day, I do not yet see that we have it right, then I'm not going to sign a bill that, for example, adds to our deficit," he said.

The House has a 256 to 178 Democratic majority, but the Senate needs 60 votes to overcome procedural hurdles — a tougher task. Also, Republicans in both the House and Senate are stoking anger and concern, arguing that they Democrats' plans would not only raise people's taxes, but also cost them their jobs.

"As Americans look up today, what they see is a big government takeover of health care that's on the table and a plan that frankly, they don't support," said House Republican Leader John Boehner of Ohio.

Interest groups have mobilized their armies on Capitol Hill to create doubts about whether government should be in the health care business.

In his remarks, Obama took on the critics.

"I understand how easy it is for this town to become consumed in the game of politics — to turn every issue into a running tally of who's up and who's down," he said.

He also said that health care shouldn't be seen as a test of his political strength.

"This isn't about me," Obama said. "I have great health insurance, and so does every Member of Congress. This debate is about the letters I read when I sit in the Oval Office every day, and the stories I hear at town hall meetings. . . . This debate is not a game for these Americans, and they cannot afford to wait any longer for reform. They are counting on us to get this done."

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